Jill Cook

@IWillLearnHowTo @ScottEpsley Isometrics for muscle strength without movement

@ProfJillCook @ScottEpsley How do I increase capacity then ? Would good rehab plan include reduced range for movement and progressing gripping strength ?

#haliburton just ruptured his Achilles. This is devastating. He had dealt with a calf strain and ankle injury. Our research showed these injuries as accounting for 26% of prior injuries accounting for AT ruptures. I’d take the risk too for the finals, but this is a real risk.

@IWillLearnHowTo @ScottEpsley Likely peritendon, avoid through range movement

@ProfJillCook @ScottEpsley What’s your take on wrist flexor tendinopathy ? Increase capacity with wrist curls or treat as perri perri avoid aggrevating moves?

@IWillLearnHowTo Less movement important

@ProfJillCook Would you say less weight (More about movement) and training twice a day with higher reps would be beneficial then ?

@ProfJillCook Should wrist tendinopathy be treated the same way as other tendon injuries? Iso for pain management and heavy slow curls &extensions ?

@JosephDeGeorge1 Have messaged someone who will get in contact

@ProfJillCook Dr Cook I live in NYC …I’ve had chronic Achilles tendinosis for a decade I just started the heavy slow loading I’m wondering if you know anyone here in NYC that is best to help me rehab this Would be grateful for any help you could provide Thank you

Interesting thread Every tendon is different in each person Subtleties in load prescription is the key skill of the clinician

@ryleyphysiothe1 @hjluks You cannot predict rupture, and if they are asymptomatic they will not be seeking management. Rupture is much more likely to happen in daily life when weight-bearing than during exercise

@ProfJillCook @hjluks So how would you know when to draw the line on how heavy to load a profoundly degenerative tendon if there are stories of people tearing tendons without any pain preceding the tear?

It's counterintuitive... but true. Tendons want a heavy load. Even if painful. Isometric loads for hot tendons should be heavy, too. Bands ?? not so much... the springiness of the band can lead to forces that piss off tendons more. And read @ProfJillCook work...

@ryleyphysiothe1 @hjluks These tendons are profoundly degenerative because of load accumulation through life Jozsa and Kannus 91 reported 66% of these tendons are asymptomatic before rupture

@hjluks @ProfJillCook What do you say to those people who tear tendons off their bone while lifting heavy? They often report no pain until the moment it pops

@LorneGoldenberg @pattiber1 @hjluks The literature is really mixed and confusing, there are a lot of treatments that have little evidence Have a look at Jason Rogers work

@ProfJillCook @pattiber1 @hjluks Jill do you have a paper or article on this you can refer us to? 🙏🙏

@hjluks @CamSwick @brian__healy Agree and the load is variable through range and often not sufficient. Load can vary day to day depending on band placement, tendons like consistent load

@CamSwick @ProfJillCook @brian__healy In general you won’t be able to generate enough load… and at higher tensions it will bounce. And that will bother a hot tendon.

@pattiber1 @hjluks Too hard to do in a tweet

@hjluks @ProfJillCook Would you address plantar fasciitis, please?

@MattR22933259 @GregLehman @hjluks Groin pain is very complex and requires differential diagnosis and management of all contributing structures Simple single tendon issues are not common

@GregLehman @hjluks @ProfJillCook Awesome thank you! I just took a look through them! If HSR may not be required for successful therapy, when do you opt to use heavy loads? What are the other benefits?

@RobinLarssonRPT @Dee_Wrecks @hjluks This more about compression between the restraining connective tissue and the tendon Primary response is in the connective tissue, tendon affected secondarily Reduce this load

@Dee_Wrecks @hjluks @ProfJillCook I assume pulley injury (i.e. annular-ligament, not tendon), and strain/partial rupture? Would suggest slow progressively increased load below pain threshold. Hangboard (feet on initially) makes load very scalable. Tape could be beneficial? (doi.org/10.1186/s13102…)

@poyzalenko @hjluks Many of the groin rehab exercises are sufficient load

@hjluks @ProfJillCook Any advice can you load up an adductor longus enthesopathy “heavy”? Cheers

@brian__healy @hjluks Energy storage and release is the highest tendon load, this is during weight-bearing athletic activity eg jumping, agility. Loads during isometrics will not be nearly as high

@hjluks @ProfJillCook can you comment more about springiness linked to aggravating tendons? ive read work discussing holding vs pushing isometrics suggesting that holding may have more utility due to some oscillating contraction during the isometric which sounds counter to your point

@c_jimenez31 @PhysioDMSilvan Wonderful idea!

A Shiny app dashboard inspired by the article “A Practical Approach to Managing Patellar Tendinopathy in the Competing Athlete.” Logs pain, trainings and rehab/strength exercises. carlos-jimenez31.shinyapps.io/Tendon_monitor… @ProfJillCook @PhysioDMSilvan

Latest from myself & @ProfJillCook in @SportsMedicineJ where we discuss sex differences in patella & achilles tendons & what it may, or may not, mean for tendon health. #tendon #mechanicalproperties #morphology #injury @UlsterSchSport link.springer.com/article/10.100…

@IWillLearnHowTo @gregthephysio Amongst others signs, yes

@ProfJillCook @gregthephysio Appreciate your answer. Would you say that positive patella grind test, pain when rest and loaded and mixed results with isometrics (sometimes they do help sometimes not really ? Are symptoms of patella femoral pain?

AND stretching a tendon injury will usually make it worse

@IWillLearnHowTo @gregthephysio No stretching for any tendinopathies

@ProfJillCook @gregthephysio Does the same apply for the patella tendon ? Stretching your quads?